Best time to take thyroxine?

Hi all, I've been struggling with an appropriate time to take my thyroxine every day. I was advised by my GP to take my meds first thing in the morning on an empty stomach but I like to get up and have a cup of tea first thing. And there's the calcium-thyroxine interaction I have to bear in mind as I have milk in my tea.

Also I get a bit of a "buzz" some time after I take the thyroxine and then "crash" later on which I don't particularly like.

So I decided to take the meds before going to bed but I've been waking up in the middle of the night if I do that. There doesn't seem to be a right time for me to take them and I was just wondering if there's anyone out there with similar issues or have found a way to make it work.


Jo xx

45 Replies

  • I take mine of an evening when there is less chance of food interfering with the absorption but have a look at this poll that was done on this site and see what others think - it takes some reading as there is 162 replies.

    Moggie x

  • Hi Moggie, thanks for the link.

    I might try to take mine when there's less chance of food interfering with the absorption but most of what I eat has milk included in it. So it's a bit of a tough one whichever way I look at it.


    Jo xx

  • Your welcome - unfortunately with levo there is going to be small sacrifices to make and mine was having to stop my milky bedtime drink (which I loved) but I would rather feel well and have no milky drink than have my treats and wonder why I am still not to good. It was my endo that pointed out the milk connection and was adamant about it.

    Moggie x

  • Hi Moggie, thanks for your advice.

    Yes, there are small sacrifices to make. The only person who advised me about my meds was the chemist about taking calcium supplements. I'm a bit surprised as to why my own doctor made no mention of it.

    Jo xx

  • I think either they don't know or they cant be bothered to take the extra few minutes it would take to explain it - I am taking iron supplements at the moment and only found out, after two months of taking them and my levels not moving, that you have to take them with VitC for your body to be able to absorb them. Also found out, from this site, that they have to be taken with food or the can damage the lining of the gut and my GP never mentioned a thing.

    Moggie x

  • How strange. I was only advised to not take milk/calcium with iron tablets. :o Which iron tablets are you taking? I'm on ferrous fumarate 210mg but I dread taking them as they taste so gross!


    Jo xx

  • Snap but mine are 200mcg's and I have been on them for 6 - 8 months now. My ferritin levels have gone from 12 to low 40's so far so still a long way to go until I reach the magic 90. I take mine with a little bit of VitC powder in strong made up orange squash straight after my lunch making sure I keep it well away from my thyroid meds - iron must be kept, at least, four hours away from your levo.

    Moggie x

  • Hi Moggie,

    I might try to invest in some VitC powder in that case. My ferritin level is currently 15 and it isn't as though I don't want to take them. I would if they weren't so disgusting. Thanks for the tip.

    Are optimal ferritin levels at 90 by chance? I was told it had to be at least 30.

    All I have to do now is time my thyroxine 4 hours after or before iron! :)


    Jo xx

  • Have a read.

    Moggie x

  • Hi Moggie, thanks for the link!

    It's interesting that the article mentions growth hormone deficiency - I'm 28 and really short - too short to be considered an adult! That as well as the fact that the levo isn't making much of a difference considering the increased dose! The only thing I don't have yet is obesity. I'm still very slim so whether it'll be a matter of time before that changes I'm not sure.


    Jo xx

  • Hi Jo, I didn't know about not taking milk/calcium with iron tablets - my GP knows I am taking both and has never mentioned this! Do you know what happens if you take them at the same time?

  • Hi Confused!!

    From what my chemist has said milk affects the absorption of iron tablets. Like yourself my GP mentioned nothing about this. Hope this helps.

    Jo xx

  • Hi Jo, Yes, that's very helpful. Thanks for taking the time to reply. Lynne xx

  • No worries Lynne! Jo xx

  • Try Lettuce Tea, I was told about that some years ago. Steep two or three large leaves of lettuce in a cup of hot water, for a few moments, and hopefully slumber sweet.

  • Lol! Not lettuce's WILD lettuce which has a mild analgesic and sedative effect. It's a herb you can get from herbalist suppliers. It's completely different from salad lettuce....otherwise we'd all be passing out after visiting the salad bar!

  • You must take first thing in the morning it absorbs strait away

  • There is absolutely no MUST about it.

    I take mine at bed-time - always have. It is quite widely recognised as a reasonable alternative and may even have some benefits. With this, as with so much else, it is important not feel compelled to take it at any particular time - each of us has to find what works for us.

    Also, straight-away means different things to different people - most of the dose will be absorbed within two hours. But it is not like some medicines which are mostly absorbed within a few minutes as the main absorption takes place after the stomach. So until the stomach empties there is very limited absorption.

  • The best time to take thyroxine is in the morning. I have my tablets at the side of the bed, a mug of water, in case I wake up thirsty. I sit on the side of the bed for a moment or two and the take the tablet with the remains of the water. That allows enough time for me to do what is necessary before going downstairs for a most welcoming cup of tea. Unfortunately, not all GPs know enough about specific conditions, if they do, they don't always pass that info on. I have been taking thyroxine for the past 12 years.

  • Hi Vivante,

    Ditto on a most welcoming cup of tea in the mornings! :)

    Yes, I was advised by my GP to take thyroxine in the morning but I found that my mood became more depressed an hour or so after taking them. I'm not sure why, but I'm wondering if it's because my body's still trying to adapt to it. I moved from a 75mcg dose to 125mcg only just recently but I moved it down to 100mcg since developing headaches which I presume was from the meds.


    Jo xx

  • I take mine in the morning too - usually about half past six to seven then I have breakfast an hour or so later.

    I tried them last thing at night and didn't feel that great doing that - think if I remember right it felt like my Carbimazole (40mcg) got a head start on the (at that time 25mcg) levo. My doctor said to take them early morning before breakfast etc as did my consultant when I said I had tried early morning. Every endo I have seen has asked specifically about how I takes meds.

    I'm amazed that two people I know who take their levo with a cup of coffee while they are having their cereal and milk breakfast and they are equally amazed at how fussy I am about how I take mine.

    Interestingly enough both of these people prescribed levo after routne blood tests showed the to be low - absolutely no symptoms for either of them.


  • Hi Liz!! Thanks for your answer.

    Yes, I mean the way levo is meant to be taken doesn't necessarily work for everyone as everyone responds differently to it. I've been advised to reduce my dose to 100mcg from 125mcg because I started to get very bad headaches.

    I'm due for a follow-up in November but I don't know what to expect from this new dosage. I haven't done very well on it at all and I've been taking the increased dosage for a little over a month.


    Jo xx

  • I know, I'm on 75/100mcg on alternate days but we've been away for three weeks in our camper van and I ended up taking 100 mcg on more days. I felt as if I was needing more the days I only had the 75mcg - I feel kind of breathless and get palpitations - Ive been alternating again this week but I think I might be needing 100 on more than just alternate days. I have put on half a stone since I was diagnosed last year ( only because I've been eating too much!) and wondered if I need more levo because there is now more body, it could also have been because I was really active on holiday - I wondered if your body can 'use your levo up'. I'm due to see the endo again in November too.

    I've never had headaches though.

    Liz x

  • Hi Liz thanks for your reply!!

    Yes, some days I've even been without the levo as I have concerns with my weight. I'm only a few ounces under 8 stone so I'm not overweight at all but I'm worried the levo will make me lose even more!

    And I've done ever so well with putting on more weight as I've been eating better but I don't want to go back to square one again if the meds are going to make me lose weight.

    It's something I want to raise with my GP but I'm worried he won't have a clue what I'm talking about. He diagnosed me hypothyroid but hypothyroid people are typically overweight and I'm not. It's so frustrating!

    Headaches could just be down to me being tired but they've started to alternate from being on the right side of the front of my head to the left. Very odd!



  • HI I take mine first thing in the morning but my GP never told me not to take with food. I have been on levo for a year and usually have with breakfast! reading these posts and I'm wondering why shouldn't you take with food i have never had any adverse effects - does it mean that i'm just not getting full benefit of the levo? or is this why I'm still tired and sluggish

  • Yes - levo needs an empty stomach so that it can absorb properly and food will stop this from happening to its full potential. Night time dosing is now recognised by GP's and endo to be the best way to take levo.

    Moggie x

  • Hello Moggie. What part of the East End are you from? Jo, I have the headaches and feel sluggish most of the day. There are days when I feel like a zombie, it's possible I am beginning to resemble one. Perhaps one day, the medical profession will know more and put us out of our misery. I have just had two cuppa's, bliss.

  • Canning Town area but I moved out years ago so that my girls could get a decent education and am now in Suffolk - bliss, although I do miss the humour of the East End.

    Moggie x

  • I lived in Bethnal Green for many years, quite close to the underground station. Loved it, although I am Welsh, I loved the cockney fun. Two of my sons are true cockneys. My grandparents lived in Bethnal Green all through the war, my gran was in St John's ambulance, they helped to rescue the people in the tube disaster. My gran felt safer sleeping in her bed, when she had the chance, Poyser Street. The flats are no longer there. I now live near Epping Forest. we moved from Vallance Road again for our sons.

    Good old days.

    Take care of yourself.

  • Work and drank in Bethnal Green for a while but mainly Stratford, Canning Town, Plaistow area. Did you ever go down the Roman Road? Cockney humour at its best.

    Moggie x

    p.s. I was born in Bow so am also a TRUE cockney.

  • Used to do shopping in the Roman Road. Loved it. Did you know the founder of Tesco started off with a stall in the Roman? My husband lived in Wyke Road, he used to box in York Hall. Victoria Park great for Sunday walks,sit near the bandstand and them swimming in the Lido.

    My husband is a true cockney.

    So much to talk about. I used to work in Woolworths in Hackney.

    So many wonderful memories.

    At our quiet times we can look back , and remember the joy we shared.

    Take care.

  • Have you read a book called "the sugar girls" its all about Tate and Lyles in the 30's but mentions all the old places, that have now sadly gone, and that cockney humour and grit. I also loved "Call the midwife" as they did some scene's down the Roman. Was absolutely appalled to see that Mary Porter (I think that's her name) series that features the Roman and how it has ended up.

    Could chat for AGES but need to get back to work. Lovely revisiting my early years with you though.

    Moggie x

    p.s. Sorry Jo for hi-jacking your questions.

  • Hi Vivante! I haven't seen your comment before, sorry!! :o

    Yes, I feel sluggish pretty much all of the day. There are also times when I get quite moody and short with my OH. I don't mean to as I love him to bits but he says and does things that annoy me. :) I also feel like a zombie, even worse when I know I have to go out shopping as I feel like everything around me is in slow-motion.

    Jo xxx

  • Thanks for your reply, Welcome to Zombieland.

  • I have been on thyroxine for years on 125 mg at 46 I am 69 now and have never been told about milk of VC also I take them when I think about it it's not to serious if you take them with what ever as you are taking them every day x

  • Hi Sugarplumb thanks for your answer.

    I'm thinking about taking Berocca as I know they're VitC supplements but I don't know if they're likely to interact with thyroxine/iron. Anything to avoid the horrible metallic taste of the iron meds!!


    Jo x

  • Like you, once I'm up I need my coffee

    So, I have a 'pill alarm' that wakes me up an hour before I need to get up.

    When the pill alarm goes off, I wake, take my pills, slug down some water, then go back to sleep for another hour.

    When my real alarm goes off, I can eat brekkie and drink coffee with no worries.

    Any other supplments etc are taken after lunch.

    I know my way won't suit all, but it suits me and I've done it this way for 3 years now.

    No matter what time I need to get up, my pill alarm is set for 1 hour before.

    Hope you find a system that works for you x

  • Hi FuzzyThyroidBrain - great name by the way!! :)

    Yes, I mean some people will have their own routine that works for them and might not work so well for others.

    I'm thinking of taking iron/VitC together in the evening and splitting my thyroid meds. I'm meant to be on 125mcg so I can take 100mcg in the morning and 25mcg in the afternoon. Only because my body's still trying to adapt from 75mcg to this big jump of 50mcg extra! :/

    Thanks for your reply!

    Jo xx

  • I always take my levo as soon as I awake which is usually about 6 ish then wait an hour and half ish before breakfast which is usually cornflakes and tea and I have had no probs at all and I have been on levo for five years now so I hope this helps

  • Hi brimstone, thanks for your reply.

    Yes, you've helped a lot! :) I've now been taking my levo upon waking and then wait an hour and a half to two hours before eating/drinking anything.

    It's just finding a routine more than anything. :)


    Jo xx

  • yes I think you are all very right. I tend to wake up in the morning, and take all my medications at once,, regardless of spreading it out or anything. So quite often I end up feeling sick, with a headache, and quite dreadful. I take 125 of Levo, which maybe I could space out a bit, and I also take slow release Tramadol, and topamax, and fentanyl patches..(which are of course, spread out over 72 hours) So I am, I guess just about at the top of what I could reasonably take. Well I still have dreadful pain. I guess I just have to learn how to put up with it!!

  • Hi marijo thanks for your answer.

    Wow - you take a lot of meds! :o I only take 100mcg at present as I feel pretty awful on 125mcg. I too have painkillers in case of any pain or headaches but I dont take them as I'm worried about how they'll make me feel.

    Jo x

  • so glad to be of help it is a bit of a pain taking levo so early especially as the dark mornings of coming but I find it works and it does not get in the way of my moring cuppa

  • Hi

    I have been taking thyroxin since July after a total thyroidectomy

    I thought I was going nuts as I too am suffering a "crash" a few hours after taking my tablet

    My TSH levels are too high & my t4 level is a bit low

    I get chest pain joint aches headaches fuzzy brain lol & I look like I'm pregnant!

    I have been taking my pill with my milky coffee not thinking it was bad

    I have looked into taking it at night & it is supposed to be absorbed better making the TSH lower without increasing the dose

    Do you wake up through the night when you take it in the morning?


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